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钆塞酸二钠增强磁共振成像时的肝实质增强:与肝硬化和慢性肝炎严重程度的形态学分级的相关性。

Hepatic parenchymal enhancement at Gd-EOB-DTPA-enhanced MR imaging: correlation with morphological grading of severity in cirrhosis and chronic hepatitis.

机构信息

Department of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki city, Okayama, 701-0192, Japan.

出版信息

Magn Reson Imaging. 2012 Apr;30(3):356-60. doi: 10.1016/j.mri.2011.11.002. Epub 2012 Jan 5.

DOI:10.1016/j.mri.2011.11.002
PMID:22227353
Abstract

The aim was to clarify whether enhancement effects of the liver parenchyma in the hepatobiliary phase (HP) of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MR imaging were correlated with the morphological grading of the severity in cirrhosis. A total of 62 patients with chronic hepatitis or cirrhosis underwent Gd-EOB-DTPA-enhanced MR imaging. Relative enhancement (RE) of liver parenchyma was calculated from signal intensity (SI) measurements obtained at precontrast images (SIpre) and 20-min postcontrast HP images (SIpost) as: (SIpost-SIpre)/SIpre. Morphological MR grades of severity in cirrhosis were divided into four groups. Then, RE of liver parenchyma and morphologic MR grading were correlated. Regarding the morphologic severity of cirrhosis, the numbers of patients with MR grade 1, 2, 3 and 4 were 14 (23%), 7 (11%), 28 (45%) and 13 (21%), respectively. The mean REs of liver parenchyma in each group of MR morphologic grade 1, 2, 3 and 4 were 0.71±0.21, 0.62±0.16, 0.70±0.22 and 0.77±0.18, respectively. There was no significant correlation between the MR grading of morphologic severity and the RE of liver parenchyma at 20-min HP. Hepatic parenchymal enhancement in the HP of Gd-EOB-DTPA-enhanced MR imaging did not necessarily decrease according to the severity of morphologic changes in cirrhosis. This fact may suggest that the hepatic uptake of Gd-EOB-DTPA depends on the preserved hepatocytes function rather than the severity of morphologic changes in cirrhosis.

摘要

目的是阐明钆塞酸二钠(Gd-EOB-DTPA)增强磁共振成像肝胆期(HP)肝实质强化是否与肝硬化的形态学严重程度分级相关。共 62 例慢性肝炎或肝硬化患者行 Gd-EOB-DTPA 增强磁共振成像检查。肝实质相对强化(RE)由对比前图像(SIpre)和对比后 20 分钟 HP 图像(SIpost)的信号强度(SI)测量值计算得出:(SIpost-SIpre)/SIpre。将肝硬化的形态学严重程度 MR 分级分为 4 组。然后,将肝实质的 RE 与形态学 MR 分级相关联。关于肝硬化的形态严重程度,MR 分级 1、2、3 和 4 的患者人数分别为 14 例(23%)、7 例(11%)、28 例(45%)和 13 例(21%)。MR 形态学分级 1、2、3 和 4 组的肝实质平均 RE 分别为 0.71±0.21、0.62±0.16、0.70±0.22 和 0.77±0.18。MR 形态严重程度分级与 20 分钟 HP 肝实质 RE 之间无显著相关性。Gd-EOB-DTPA 增强磁共振成像肝胆期肝实质强化并不一定随着肝硬化形态变化的严重程度而降低。这一事实可能表明,Gd-EOB-DTPA 的肝摄取取决于保留的肝细胞功能,而不是肝硬化的形态变化的严重程度。

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